The COVID-19 pandemic radically changed the way America’s hospitals work and the burden put on hospital staff, doctors, and nurses. In hard-hit areas, intensive care bed availability disappeared, and other hospital beds were turned over to people who contracted the virus. Emergency rooms overflowed and some patients were put in only makeshift beds, in some cases for days. Hospitals began to lose key personnel because they felt entirely overwhelmed or became infected. (These are the 16 states where hospitals are experiencing the worst workforce shortages.)

Emergency rooms have been the “front doors” to hospitals for years, particularly facilities that treated people without insurance or other means to cover medical expenses. The spread of COVID-19 undermined the ability of ERs to perform this function, and waiting times for care became longer and longer – in the case of Maryland, the state with the longest median emergency room waiting time – an average of 228 minutes (almost four hours).

According to research by the IT service automation company SysAiD based on data from the Centers for Medicare & Medicare Services, emergency room median waiting periods in all 50 states topped 100 minutes between Jan. 7, 2020 and March 31, 2021 – a period that would have seen the serious inflows during the worst of the pandemic. 

Supplemental data on COVID-19 death rates and the number of doctors per capita came from the Centers for Disease Control and Prevention. Data on hospital beds per capita came from the Kaiser Family Foundation.

Click here to see the states with the longest emergency room waiting time in America

The most notable conclusion of the study was that sparsely populated states had the shortest emergency room waiting times and crowded states had the longest. The state with the shortest waiting time was North Dakota at 104 minutes, followed by South Dakota at 113 and Nebraska at 114. The state with the longest waiting time was Maryland, the only one with an average wait time of more than 200 minutes. (These are the best rural hospitals in the U.S.)